Enfermedad invasiva por Streptococcus pyogenes: cambios en la incidencia y factores pronósticos
- María del Carmen Suárez Arrabal
- Luis Alberto Sánchez Cámara
- María Luisa Navarro Gómez
- M. M. Santos Sebastián
- Teresa Hernández-Sampelayo Matos
- Emilia Cercenado Mansilla
- Jesús Saavedra Lozano
ISSN: 1695-4033, 1696-4608
Year of publication: 2019
Volume: 91
Issue: 5
Pages: 286-295
Type: Article
More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Abstract
ntroduction:InvasivegroupAstreptococcaldisease(iGASD)isaseriousinfectioninchildren.Severalstudieshaveshownanincreasedincidenceinthepastyears.Objective:ToevaluatethecharacteristicsandoutcomeofiGASDinchildren,andtodeterminechangesinincidenceorseverity.Materialandmethods:Aretrospectivestudywasconductedonchildren≤16yearsevaluatedinatertiarypaediatrichospitalinMadrid,anddiagnosedwithiGASD(June2005-July2013).Ananalysiswasmadeofthedemographics,symptomatology,microbiology,andtreatment.Thechangesthroughouttheperiodstudiedwereevaluated,aswellasparametersassociatedwithdiseaseseverity.Results:Thestudyincludedatotalof55childrenwithiGASD,with33(60%)females,andamedianageof48.5(20.5-88.9)months.Themostfrequentclinicalsyndromeswerecellu-litis/subcutaneousabscess(21.8%),ENTabscess(20%),pneumonia(16.4%),osteoarticularinfection(16.4%),andmastoiditis(12.7%).TheincidenceofiGASD(cases/105emergen-cies/year)increasedfrom5.6(4.2-7.2)betweenJune2005-May2009to18.9(15.1-26)betweenJune2009-May2013;P=.057.SurgeryandadmissiontoPICUwasrequiredby35(63.6%)and10(18.2%)patients,respectively.ChildreninPICUwereyounger(26.5vs52.6months,P=.116),hadahigherC-reactiveprotein(24.5vs10.7mg/dl,P<.001)andhigherfrequencyofpneumo-nia(60vs7%,P<.001).Inthemultivariateanalysis,onlyC-reactiveproteinwasariskfactorforadmissiontoPICU(OR:1.14[1.004-1.286],P=.04).Therewerenosequelae.Conclusions:AnincreasedincidenceofiGASDwasobservedinthechildreninthisstudy.Lowerage,pneumonia,andhigherC-reactiveproteinwereassociatedwithdiseaseseverityinthisseries